Breast Cancer - Medtick

Breast Cancer

What is it?

Cancer of the breast.

There are many types of breast cancer:

  • Non-invasive breast cancer
    • Found in ducts of breast and has not spread.
  • Invasive breast cancer
    • Found in ducts of breast and has the ability to spread i.e. HER2+ breast cancer
      • HER2+ breast cancers are of larger tumour size and higher grade and are more likely to have lymph node metastases

Pathmanathan N, Provan PJ, Mahajan H, et al. Characteristics of HER2-positive breast cancer diagnosed following the introduction of universal HER2 testing. Breast. 2012;21:724-729. 

Breast screening
All women aged 50 years old and older should have breast screening every three years.

Cause

  • A non-cancerous lump
  • Consuming alcohol
  • Smoking
  • Being tall
  • Age at diagnosis:
    • At a younger age one has more breast tissue to produce milk. The more breast tissue one has the more chance to get cancer and the also it is harder to spot the cancer.
    • As one gets older one has less milk producing glands (replaced by fat) and the easier it is to identify the cancer, hence most cancer is identified at an older age: 50 years and over.
  • Breast density- females who have more breast tissue have a higher chance of breast cancer and also it is harder to spot the cancer.
  • Family history of breast cancer:
    • The no. of relatives affected, particularly the same side of the family
    • Disease in both sides of affected relative(s)
    • Multiple cancer in affected relative(s)
    • Early onset of tumours (e.g. ovary, pancreas prostate, carcinoma, adrenal carcinoma) with in the family
    • Male breast cancer within the family
    • Known cancer genes within the family (BRCA1 carries 65-85% breast cancer risk and 40-50 cancer risk, BRCA2 carries 40-85% breast cancer risk and 10-25% ovarian risk others: TP53,PTEN and STK11)
  • Having children at an older age
  • Late menopause
  • Overweight – particularly post menopausal women who have high abdominal fat which is responsible for most of circulating oestrogen.
  • Hyperprolactinemia
  • Paget’s disease
  • Adenoid cystic carcinoma (ACC)
  • Previous diagnosis of breast cancer
  • Started period at young age

Treatments

  • Radiation exposure- i.e. regular exposure to x-rays, Ct-scans, radiotherapy, and radiation leaks

Syndromes

Medication

  • Contraceptives
  • HRT
  • Oestrogen supplements

Vitamins, herbals and minerals

Symptoms

(Not all lumps cause cancer)

  • Change in size or shape of either or both breasts?
  • Lump or thickness of breast tissue of either or both breasts?
  • Change in the way nipple looks in any way?
  • Discharge from nipples (can be bloody) of either or both breasts?
  • Pain and/or swelling in breast or armpit area not related to your period?
  • Rash on or around one’s nipple?
  • General discomfort (muscle weakness), uneasiness or ill feeling (malaise) and/or fatigue (tiredness)?
  • Unexplained weight loss?
  • Hard Painless lump and/or not moving and and/or is becoming larger?
  • Back pain?

Complications /Information to beware of/General tips:

Do not wait phone for ambulance if have or develop

 


Urgent Referral to Medical Doctor (including Inflammatory breast cancer)

  • Urgent referral is warranted when women who are 50 years of age or older present with nipple discharge or retraction in one nipple only or with any other concerning changes.
  • Women aged 30 years or older who present with an unexplained breast lump, with or without pain
  • Women aged 30 years or older who present with skin changes that are suggestive of breast cancer
  • Women aged 30 years or older who present with an unexplained lump in the axilla

Inflammatory breast cancer

  • Patients may present with a rapidly enlarging, erythematous (rash) breast without an underlying palpable mass.
  • Usually, there is a spreading colour change in one breast, typically evolving from pink to darker red in a mottled pattern.
  • Patient with a red breast include previous history of breast cancer, symptoms of mastitis in a non-lactating woman, and/or  swollen glands and/or lymph-nodes (see picture above)
  • Crusting and retraction of nipples may or may not occur.
Do not wait to see a a medical doctor as, inflammatory breast cancer can exist with cancer that can spread to other parts of the body.

Confirmation is when:

  • Rapid onset of breast erythema, oedema and/or peau d’orange, and/or abnormal warmth with or without an underlying palpable mass
  • Duration of history no more than 6 months
  • Erythema occupying at least one third of the breast
  • Pathologic confirmation of invasive carcinoma (cancer)

https://www.ncbi.nlm.nih.gov/pmc/articles
/PMC8446552

Non-urgent referral

  • Non-urgent referral should be considered when patients under the age of 30 years present with an unexplained breast lump with or without pain.

England’s National Institute for Health and Care Excellence (NICE), urgent referral (appointment within 2 weeks) for imaging and further evaluation for breast cancer


Always Check your breasts

  • Cowden syndrome
  • Always check breasts:
    • For any lumps or swelling
    • Skin opening of the breast
    • Breast is warm than the rest of body
    • Change of breast colour
    • Big increase of breast size (after puberty)
    • Anything unusual
This cancer can always reoccur, constant checking is essential: it can occur locally in breast  or one can have cancer in other parts of the body. If in doubt see your medical doctor

This condition can lead to spreading of cancer in other areas of the body (secondary breast cancer) by the time it is detected (stage 4):


This cancer has been associated with:


This condition may show similar symptoms to:

  • Gigantomastia/Macromastia (Breast hypertrophy)
  • Gynecomastia
  • Fibrocystic breast changes:
    • Noncancerous condition can cause a variety of changes in the breasts, including the accumulation of water in the breast tissue.
    • When your breasts swell and fill with fluid, they’ll feel heavier than usual.
    • These changes can happen in one or both breasts.
    • They might occur every month at a certain point in your cycle or follow no discernable pattern.
    • In some cases, you might have constant symptoms.
      • Free-moving lumps
      • Pain or tenderness that’s often worse right before your period
      • Pain that extends into your armpit or down your arm
      • Appearance or disappearance of lumps or lumps that change size
      • Green or brown nipple discharge
      • As cysts appear and disappear in your breasts, they can cause a scarring and thickening of the breast tissue, called fibrosis (fibrosis). You can’t see these changes, but they can make your breasts feel lumpy or heavier than they used to.

Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist) for further advice

Detailed Information

Please copy and paste any key words from the title: Breast Cancer in the following respective 'Medtick References and/or Sources' to find out more about the disease (this also may include diagnosis tests and generic medical treatments).

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  • Medscape

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  • Pharmaceutical Journal

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  • WebMD

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  • Cleveland Clinic

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  • Drugs.com

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  • Verywell Health

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